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Case Reports
. 2023 Jan 9:9:1068935.
doi: 10.3389/fsurg.2022.1068935. eCollection 2022.

Case report and literature review: Primary leiomyosarcoma of the penis

Yichang Hao  1 , Li Xia  1 , Min Lu  2 , Chenhong Liu  1 , Fan Zhang  1 , Ye Yan  1 , Yi Huang  1 , Shudong Zhang  1
Affiliations
Case Reports

Case report and literature review: Primary leiomyosarcoma of the penis

Yichang Hao et al. Front Surg. .

Abstract

Background: Leiomyosarcoma (LMS) is a malignant spindle-cell mesenchymal tumor originating from the smooth muscle cells, which mostly affects soft tissues and abdominopelvic organs over extremities. Primary LMS of the penis is a relatively uncommon mesenchymal tissue disease and a poorly understood condition.

Case report: A 69-year-old man presented with a growing, painless mass protruding from the penis. The irregularly lobulated lump was roughly 3 cm × 2.5 cm, with a smooth surface, tough texture, distinct boundary, and no tenderness. It was determined to be a penile tumor during the preoperative radiological evaluation. The patient underwent resection of the penile mass, followed by extended resection in the second operation. The diagnosis of LMS was verified by pathological examination. During a 20-month follow-up, the patient made a smooth recovery and remained disease-free.

Conclusion: An immunohistochemical examination is essential for rendering this rare diagnosis. Radical excision of tumor lesions with negative cut margins is guaranteed to be the best treatment for primary penile LMS. Close follow-up should be provided due to the high rate of local recurrence.

Keywords: case report; leiomyosarcoma (LMS); malignant mesenchymal tumors; penis; urogenital neoplasms.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Preoperative pelvic MRI (male genital system) showed nodular mixed signal shadow in the distal penis (arrow head), with a size of about 31 mm × 27 mm × 22 mm, and a high signal on DWI. (A) Transverse section, T2-weighted imaging. (B) Coronal section, T2-weighted imaging. (C) Median sagittal section, T2-weighted imaging.
Figure 2
Figure 2
Pathological examination showing that the mass was composed of atypical spindle-shaped cells tumor with focal necrosis. (A) Hematoxylin and eosin (HE) staining with high mitoses and atypical mitoses (×40). (B) Immunohistochemistry staining of SMA (×40). (C) Immunohistochemistry staining of Caldesmon (×40). (D) Immunohistochemistry staining of Ki-67 (×40).
See this image and copyright information in PMC

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